一个年轻成年人的异卵巢中腺瘤的继发性持续性原发性甲状腺炎:一个病例报告
Karl Homer Nievera1, Rebecca Alba1
1Section of Endocrinology, Diabetes and Metabolism, Chinese General Hospital and Medical Center, Manila, Philippines.
Journal of the ASEAN Federation of Endocrine Societies
|December 4, 2023
概括
异位副甲状腺瘤可以导致年轻成年人的持续性高血症和骨质疏松症. 早期怀疑和先进的成像对于诊断和手术治疗这些罕见的,具有挑战性的病例至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 放射学 放射学是一门学科.
背景情况:
- 初级甲状腺功能障碍症 (PHPT) 通常影响绝经后的女性,但也可能发生在年轻人身上,通常是由于甲状腺腺瘤.
- 副甲状腺切除术后持续的高血症可能表明异位副甲状腺腺瘤,需要专门的诊断和手术策略.
- 异位副甲状腺瘤占初始手术后持续PHPT病例的6-16% .
研究的目的:
- 报告一个年轻男性患有异位副甲状腺腺瘤引起的症状性高血症和骨质疏松症的病例.
- 突出介质侧甲状腺腺瘤的诊断挑战和管理.
- 强调在持续的PHPT中怀疑异位腺瘤的高指数的重要性.
主要方法:
- 一名21岁的男性患有严重的高血症,骨折和骨质疏松症,接受了生物化学和成像工作.
- 最初的塞斯塔米比扫描表明中外侧甲状腺腺瘤;然而,最初的部探索未能定位它.
- 胸部CT证实了中腺瘤,导致成功的重新手术和腺瘤切除.
主要成果:
- 该患者出现了症状性高热血症,股骨骨折,棕色瘤和骨质疏松性骨密度.
- 最初的副甲状腺切除术由于腺瘤的异位介质位而失败了.
- 第二次手术成功切除了宫外腺瘤,使甲状腺激素 (PTH) 和水平正常化.
- 术后饥饿骨综合征是通过补充管理的.
结论:
- 年轻患者的持续性副甲状腺症和二次性骨质疏松症需要对异位副甲状腺腺瘤进行调查.
- 像CT这样的先进成像对于定位最初探索期间错过的宫外腺瘤至关重要.
- 及时诊断和手术管理,包括必要时重复手术,对于成功治疗和预防饥饿骨综合征等并发症至关重要.
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